Face-transplant pioneer to carry on after patient death

A French pioneer of face transplants, whose most recent patient died on Monday, has vowed to carry on developing his ground-breaking surgical techniques.

The patient was the seventh in the world to receive a face transplant, but the first burns victim to undergo the procedure. Surgeon Laurent Lantieri of the Henri Mondor Hospital in Creteil says that despite the man’s death, a huge amount has been learned through the procedure.

“It would be a shame, and unethical to stop now,” Lantieri told New Scientist. “A man died for this cause, and it would be unethical not to take the programme forward,” he said.

The patient who died had been disfigured by fire, losing not just most of his face, but his fingers as well. In April, Lantieri and his colleagues spent 30 hours transplanting almost an entire new face onto the man – from just above the lips – as well as two new hands.

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Burn link

On Monday, 15 June, however, the 30-year-old patient died of a heart attack during surgery to combat a serious facial bacterial infection. Lantieri says that preliminary investigations have ruled out any link with the transplant itself. “It doesn’t seem that there’s any correlation,” he says.

The infection was of Pseudomonas bacteria, which are often a problem in burns patients, again suggesting that the transplant itself was unconnected.

Lantieri says that armed with the data the patient provided his team is better prepared than ever before to treat subsequent burns patients.

“I’m very confident for the future,” he says. “We now have data, and we know about problems and how to solve them, even though the patient died. In future, we think we can control infections, the immunosuppression to prevent rejection, and reduce the time taken for the operation.”

Surgical success

The patient is the first to receive new eyelids, and these apparently worked well. “They were moving,” says Lantieri. He says that transplanting each eyelid is tricky, because the inner muscle of the eyelid needs to be transplanted as well as the visible outer parts, so that the eyelids can be raised and lowered.

Lantieri said that he has a waiting list of patients, and “we will go forward”. “The death has made it more, not less imperative to go on,” he says.

Restored functions

The most important justification for face transplants, say Lantieri and other pioneers, is that unlike ordinary skin grafts which simply repair the surface, they contain nerves and muscles that merge with the patient’s own tissue. This enables damaged areas of the face to move and so can restore lost functions like smiling, eating, speaking and – in the case of the dead patient – moving eyelids.

The dead man was Lantieri’s third face transplant patient. The first, a man whose face was obscured by a benign tumour, is still doing well. In March, Lantieri successfully fitted a face containing facial bones to a man who had suffered a gunshot wound.